Welcome, Tim, sorry to see you here.
Please read the sticky on the front page entitled "Newly Diagnosed with PC? Read this first." One of the key points is that a second opinion from Bostwick or Epstein on your biopsy slides is a good idea.
The University Hospitals Seidman Cancer Center in Cleveland is building a new proton machine. I don't know if it's yet
open or if they plan to use it for prostate cancer. The controversy with protons is that they are expensive and do not seem to be any better than IMRT. They have started clinical trials to definitively determine that.Meanwhile, many private insurers are refusing to cover it.
IMRT, in turn, is more expensive and has never been shown to be any better than SBRT (which began in 2003. There are always better mousetraps. The Seidman Cancer Center does SBRT as well, although I'm not familiar with their practitioners. Lee Ponsky does CyberKnife (a brand of SBRT) at Case.
On the brachy side, both LDR and HDR monotherapy have excellent outcomes with your kind of cancer. Jay Ciezki at the Cleveland Clinic just published some very impressive results with LDR. For HDR, you can't beat Alvaro Martinez in Detroit.
Surgery would probably work just fine too. I don't know the surgeons in Cleveland. I'm sure there are some good ones at the Cleveland Clinic.
One thing you'll quickly learn is that a specialist in one therapy knows very little about
other therapies. That means the burden falls upon you to go out and interview specialists in each technique. In my experience, surgeons are ill-informed about
the latest radiotherapy advances and vice versa.
Allen - not an MD
•PSA=7.3, prostate volume=55cc, 8/17 cores G6 5-35% involvement
•SBRT 7 year results
treated 10/2010 at age 57 at UCLA
•PSA since treatment:
1/11:3.9 5/11:3.0 8/11:3.7 5/12:1.2 9/12:1.3 5/13:0.4 6/14:0.5
• SEs of treatment:
after 2 wks: mild urinary & rectal - last 1 wk
1 yr after: mild urinary